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Third generation IVF Plus- Personalized Precise Implantation

Maybe you've been there, the transfer failed over and over again. Even with PGS, still get nothing. If someone tells you that with a good blastocyst and  transfer at the right time. Pregnancy rate will rise to 80 %, Do you believe it?

Timing! Is either too early or too late, like a boy and a girl meeting at wrong timingno good will come of it. It's hard to develop into a zygote (2PN) if the post-thaw mature oocytes form the oocyte bank fertilized at an improper time. That's why we use polscope to observe whether oocytes are fully expended or not. So we can perform fertilization accurately. Making post-thaw embryos have same fertilization rate and blastocyst rate as the fresh oocytes. However, is there a precise implantation timetable for bedding, as known as the WOI(window of implantation)?

Miss G, 43-year-old, from Beijing, picking up 6 oocytes at her last operation, transferring 3 early-stage embryos, but still didn't get pregnant. She came to our center looking for donated-oocytes. Then we quickly matched a donor with 12 mature oocytes for her. The post-thaw survival rate was 100%  and thankfully 11 fertilized egg were cultured into blastocysts. With lots of confidence and expectation, two blastocysts was transferred. However, we didn't win the battle. In the next month, we repeated the process. β-HCG topped at 126 and dropped. Those oocytes quality was good as donors were in their twenties. Theoretically, the pregnancy rate could have been up to 90% by transferring 4 blastocysts in total. But the devils was in the details, we suggested her to take ERA(Endometrial Receptivity Array), nevertheless, she wanted to give it another shot before ERA.

After taking a three-month break, transferring 2 blastocysts still bring us nothing. I called her after the pregnancy test result was released, but her husband lost all his faith, and planned to go all the way to the U.S, exploring for another clinic. I said give it a chance to the ERA! The ERA report indicated that the best bedding time would be at 144 hours after the progesterone infiltration. We did the first 3 implantation wrong. But with two blastocysts , precise implantation, and hallelujah, the β-HCG value went up to 1,989. She rejoiced in her pregnancy hood.

For the longest time, doctors has been using their experiences, transferring blastocyst(s) after giving progesterone for 5 days(120±3hrs). But after the long-awaited 15 days and still have only one line on the pregnancy test, yet don't know why? "Probability" or "abnormal chromosome of blastocysts" are the only comfort words to appease clients.

Indeed 60~70% of implantation failures are due to a chromosome abnormality, even some survive from the first round. Miscarriages are more likely to happen within 3 months, only a few exceptions will be given birth, eg. down syndrome babies. We recommend PGS for clients to avoid history repeats itself. Even though with the precise selection, transferring good blastocysts for few times and still get nothing ? What happened?

37-year-old Miss L, from Taiwan, had to abort because she was carrying a down syndrome baby. This time she asked for PGS. For the first oocyte retrieval, we picked up 10 oocytes and created 4 blastocysts. 2 out of 4 had normal chromosome, we transfer 1 blastocyst but failed. The second time, we transferred 1 blastocyst again but failed again. She thought that ERA was unnecessary due to past experience of natural pregnancy. With no normal blastocyst left, we had to operate again to pick up more oocyte. This time, 14 oocytes and cultured 6 blastocysts. We examined 4 blastocysts with PGS, only 1 of them is normal. For caution’s sake, we arranged ERA. Surprisingly, the WOI is also 144 hours after the progesterone infiltration. According to the result, with a normal blastocyst, precise transfer, β-HCG reaches 7,294! Hooray!

People become irrational when they losing faith, folk remedy, DHEA, Q10, inositol(vitamin B8), melatonin, vitamin D3… they eat at all they can, feeling like it is better than just doing nothing. On the other hand, the minority who still believe in science throw themselves to immunotherapy, even with normal immune index, human Immunoglobulin(IVIG) and heparin are injected as a drowning man will clutch at a straw. However, the result of spending more money is still the same, the truth has not been revealed yet.

Think about it! What else is unknown in reproductive sciences? Did we miss something between PGS and immunologic rejection? The blastocysts with normal chromosome will be accepted by the uterus no matter in what kind of circumstances? Other than having an ideal thickness of endometrium lining(10±1mm). Does everyone have the same scheme of progesterone infiltration?

The brand new ERA is to analyze the expression levels of the 236 genes from the endometrium cells. An informatic predictor is used to determine how long does progesterone infiltration take. That will lead us to the best bedding time. We call that "personalized precise implantation"
Since the technology was introduced in 2015, more than 40,000 big data have been accumulated so far, showing that up to 28.6% of the implantation time was wrong. That means, with only the doctor's experience, ¼ of the time is wrong.

More than 40% of our clients are from overseas. Many of them travel around, visiting several clinics. Various doctors, multiple implantation, but with the same resultstill not pregnant. Most of these clients’ ERA result is different than others’, progesterone infiltration takes 12~24 hours longer. A very few of them takes 12~24 hours less. Usually, it takes only one implantation to get pregnant after adjusting the progesterone infiltration time. Only a handful need to take further treatments due to the immune system problems. We suggest her finishing ERA first to avoid wasting valuable time and embryos on the wrong way. Regard it as an upgraded version of the third generation of IVF (IVF 3.0+).

Trust Sciences! Trust Genetics! The pregnancy rate of transferring a good blastocyst with PGS+ERA can reach at 80%. On the other hand, 10~20% increase compared to those with PGS, only 60~70%. This is the Third generation IVF Plus: “precise selection + precise implantation”.

1. Miss G, from Beijing, IVF with donated oocytes
  Implantation results are as follows:

2. Miss G's ERA report:

3. Miss L, from Taoyuan, IVF with own oocytes
  Implantation results are as follows:

4. Miss L's ERA report:

Stork Fertility Center送子鳥 Stork Fertility Center送子鳥 Author

Never give up for having a baby-Oocyte Donation Program

Faith means believing the unbelievable.

When we are the freshmen of Stork Fertility Center, we have the training program.
One of the course is that we need to entering the examination room, listening doctor's treatment and how to communicate with patients in order to make our advisory smoothly. 
When the patients tell their own story about the desire of having baby, we more understand what they have been through, and how they want this treatment bring result as expectation. That's why each movement we do is assigned a responsibility. Moreover, this follow-up process will strengthen the establishment of empathy and the special emotional connection with patients.

One of my training program, there is one couple makes me impressive.
"Did you use the pregnancy test kit at home?" doctor asked. I think that doctor try to make examine room more relax to ask this question. The husband said " No, we are too nervous to test by ourselves." And the wife didn't say anything next to husband. As the doctor open and show that pregnancy strip test, ask the couple "Could you recognize the second line on the test kit?" Suddenly, the husband popped up and said " I knew it. I pray to God last night, and ask the priest. See! Look at my Line message. He told me so in this message." Compared with silence wife, husband looked to excited. They pray, pray a lot, pray sincerely. I could see their joy in their eyes. However, that's my first time and the only one to meet this joyful couple. And I kept the wife's name in my note.

In this electronic and internet generation, people could make friends without face-to-face. Reading all the medical record of this couple, it could tell why they come to Stork fertility center and how hard and serious they try to have the baby. After reading the paper of medical record, I think I become more familiar with them.

They began the treatment in Stork fertility center in 2015. After some examination, we are quite sure that tubal and uterus are no problem. However, due to their ages, they registered for oocyte donation program. we matched a young and appropriate donor soon, and we got total 12 mature eggs for this time. The donor gave us 19 mature eggs, and eight blastocysts derived. Two embryos were thawed, and they were graded as 4BB and 4BA. They would have started the first course of treatment, but due to the wife’s persistent bleeding, they decided to cancel after discussion with the doctor. They started the second treatment with transfer a 4BA embryo, but still haven't good news yet. 

However, due to the last embryo, the couple were worried about if they still don't have the good news with second transfer, they will spent more time to match another oocyte donor. So we spent a little time to have second match. Soon and later, we got 10 mature embryos. In the same time, second transfer have been finished, and they still don't get the result they want.
 We could tell how aggressive of this couple by read the schedule of treatment. And the third time transfer, also the final transfer with a best 4AB embryo. Now, they are about to have a baby, and finally almost graduate from this long journey. There are 15 lessons for entering examine room of training program. We could see people cry, people laugh with doctor's announcement in the room. They are the most excited couple I have ever seen with succeed result. From their talk, I know they are convinced Christians. They repeatedly said how hard they pray, and they believe that they will become the parents one day.

Faith, is all around the world. Seeing this couple even face some difficulties, but they haven't been defeated. I will share this story to my customers, and tell them "Faith means believing the unbelievable."

Stork fertility center hold the "Annual Stork Party" every year. The purpose of this dinner is to invite the parents bring their IVF baby by Stork. They could share the joy with doctor, and let we could how big babies are. Due to we see all these babies from egg to embryo, and now they are sweet babies. Also the parents could share some different life experience with baby. What's more, the party could remind us the original intention of work "Sweet baby, Sweet home".

Remember, please come back to our Annual Stork Party after you graduate from this long journey.

Faith, is all around the world. Seeing this couple even face some difficulties, but they haven't been defeated. I will share this story to my customers, and tell them "Faith means believing the unbelievable."
Stork Fertility Center送子鳥 Stork Fertility Center送子鳥 Author

An Unreachable Dream Comes True - Sperm Donation Program

Some people may spend a couple years to have their own child, and some may spend longer than even a decade to have one. However, for the latter group of people, having a child and to organize a family can seem to be an unreachable dream.

In 2014, I got a call from Jack, who spoke to me in depth and with vigor. He wanted to consult with me about a sperm donation program, and then he left his contact information. We started the sperm donation consultation. At that time, the consultation was a big challenge for me because I had just started working at Stork fertility center. I was really nervous to reply to Jack's email the first time, but his positive attitude always gave me motivation to answer more of his questions. After a couple of months talking through E-mail with Jack, I get to know about Jack, and he is a transsexual person. Within a traditional Asian culture, I couldn’t imagine how hard that would be. Jack still made this decision, and he wanted to build his own family now.

Jack and his wife, like any other couple, have enjoyed the world of two, but they wanted to have their own child. However, Jack worried that his identity (transsexual person) would be a problem to do the sperm donation program. After a lot of research and work, Jack got our information from online and he pumped up his courage to get in contact with us. He was on the way to start having his dream come true.

Eventually, Jack and his wife cam to Stork fertility center. I made a schedule that included the time for when they came to Taiwan, as well as when to start the BT (Blastocyst Transfer).

A couple months later, Jack and his wife came to Taiwan a second time. They told me that they quit their original jobs to make sure that they could focus on the treatment. This time, I could feel how strongly determined they were to have their own child. However, after the transvaginal ultrasound, the doctor didn’t see too many primary follicles (which later become an egg). Although finding this outcome is really frustrating for everyone, Jack and his wife pick up the pieces and carry on to the next treatment.

On the day that Jack’s wife had to do the OPU (Oocyte Pick Up), I can see how nervous Jack was from his face. Eventually Jack’s wife goes in for treatment. The surgery did not take too long, and everything is going very well. Jack and his wife move on to the next stage, Embryo Culture.

Two weeks after BT (Blastocyst Transfer), I check my E-mail frequently and from time to time, just wanting to see if there was any news coming from Jack. Heaven helps those who help themselves, and I finally heard news. Jack told me that his baby’s condition is good, and that he got a new job as well. In July 2016, Jack and his wife’s dream has come true. They have their own child, and their own family.

Stork Fertility Center送子鳥 Stork Fertility Center送子鳥 Author

A Long Journey, A Solid Friendship-Sperm Donation Program

At the end of 2014, when I was planning to go watch the fireworks show at Hong Kong’s Victoria Harbour to celebre the new year, I got Maddy’s message. In this Message, she told me that she delivered a healthy baby. Therefore, I suddenly got an idea which is going to visit Maddy’s home and to see her baby.

How did I meet Maddy? The Answer is an international phone call from Hong Kong. In this phone call, I discovered why Maddy and her husband chose to go Taiwan for IVF treatment (In vitro fertilisation). Her husband has Azoospermia( which is the medical condition of a man whose semen contains no sperm. ) due to him getting mumps when he was a child. They wanted to do a sperm donation program. Then I started to help Maddy to figure out how to reduce the cost for doing IVF in the Taiwan, and plan a personal treatment schedule for Maddy(she just need to come to Taiwan only few times to finish this whole IVF treatment).

I had very hard time to understand Cantonese when I spoke with Maddy’s husband when we first met. Fortunately, Maddy translated what her husband said perfectly in Mandarin to me. It really helped us when we got into our first OPU (oocyte pick up) and BT(Blastocyst Transfer). However, the BT did not at first bring us good news. Maddy wasn’t pregnant, but she still kept her positive attitude and actively continued the next OPU.(because Maddy wants two babies and she only had one Embryo left at that time)

During Maddy’s second time treatment, she told me that her mom will come to Taiwan with her ,and they will stay in Taiwan for one month. Apparently, housing will be a problem for Maddy because there are few affordable Hotels in Taiwan for one month. Thus, I help her to find a short term rental. Eventually we became neighbors, with Maddy renting an apartment near my apartment.

After I met Maddy’ mom, I immediately know where Maddy got these positive attitude and optimistic personality. Maddy’s mom not only helped cheer Maddy up everyday, but also took care Maddy’s daily meals with her wonderful cooking(I was invited to have dinner with them couple times). A few weeks later, The outcome of this time’s OPU was great, we got 12 eggs. 8 out of 12 are successfully fertilized in the same day. Finally, Maddy got 6 good embryo. 15 days later, Maddy is pregnant. When Maddy was on her way home(Hongkong), I saw her husband come pick her up back. I know this baby is the best souvenir to them in this long trip.

As a IVF consultant, helping our customers to conceive is our job. However, I feel something more than the job this time. Maddy and me build a friendship through this job. Maddy now has an energetic little girl.
Stork Fertility Center送子鳥 Stork Fertility Center送子鳥 Author